Venous leg ulcers in the UK: the local burden of illness and the allocation of resources

The precise UK prevalence of venous leg ulcers (VLU) is currently unclear. Prevalence data is essential in order to calculate the costs and, to measure the impact of any therapeutic intervention. A review of the literature was undertaken to assess the prevalence and costs of VLU in order to collate available data for baseline, or comparative purposes. Thereafter, information on compression bandaging products obtained from the QuintilesIMS database, prescribed for one large city was collected and calculations made to estimate known prevalence in that geographic locality. Results from the literature search showed the prevalence to vary from 0.1% to 1.1% in the studies identified. The prevalence of leg ulcers (LUs) in compression in the city reviewed was calculated to be 0.1% in 2015. There is a lack of reliable information on the prevalence and cost of LUs. The estimated prevalence reported is in keeping with those calculated by SIGN (2010) but less than those reported by Guest et al (2016). The annual cost of treating patients with LUs in the UK has recently been reported to be £1,938 million (Guest et al, 2016). Traditionally, regional clinical commissioning groups (CCGs) and local health authorities have not requested prevalence and outcome data on LUs and, therefore, there is a gap in understanding the extent of the problem. Consequently, the budgeting of services by CCGs is based more on estimates than on prevalence data. Without more accurate prevalence data it is impossible to truly understand the scale of the problem and develop a plan on how best to move forward with improving LU care.